Psychopathological

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Psychopathological re-engagement

Psychopathological repercussions differ from each other and depend on the nature of the psychological trauma. People with such re-appeals usually have the most acute symptoms of post-traumatic stress disorder.

One of the features of these experiences is obsessive memories and thoughts about the trauma. Patients usually recall the sad events they have experienced in the past, such as the death of others.

In addition, it can be frightening memories, because during a psychological trauma people usually have a strong fear.

Sometimes memories of the past make a person feel guilty, sad or afraid. Even if a person does not remember specifically, but simply encounters something that reminds him of a trauma, he begins to feel tension, anxiety and insecurity.

For example, we often notice that soldiers coming home from the points of military operations are constantly worried and uncomfortable in situations in which they feel vulnerable. They constantly monitor the opening and closing doors and behave cautiously in crowded places.

In addition, their excitation system is quickly activated, they are often tense, irritable, they have anxiety attacks. They can face this, even when they do not think about trauma.

Typically, psychopathological repercussions are short-lived and last one or two minutes. But when a person experiences psychopathological re-gratification, they react poorly to the influence of external stimuli. However, if you talk with a person with psychopathological repercussions and can get him involved in a conversation, you can make this re-training shorter. In addition, there are medications, such as Valium, that help people relax in such situations.

Symptoms and Diagnosis

The main symptoms of posttraumatic stress disorder are obsessive thoughts about the injury, hyperexcitation, and sometimes shame, guilt. Sometimes people can not experience emotions and behave like robots in everyday life.

In other words, people do not experience any emotions or experience any specific emotions, such as pleasure.

In addition, they constantly feel that they have to defend themselves, they are in a state of anxiety, they have some symptoms of depression. These are the main groups of symptoms of post-traumatic stress disorder.

It would be nice if there was a kind of biological test that would tell us whether a person has PTSD without checking the symptoms. But in general, PTSD is diagnosed by obtaining from the patient all the details of the history that occurred to him, and then examining the history of each symptom. There are several diagnostic criteria, and if you observe a sufficient number of symptoms, then you can diagnose PTSD. However, there are people whose disorders do not meet the criteria for diagnosis, because they do not have all the symptoms, but nevertheless there are symptoms associated with PTSD.

Sometimes, even if you do not fully meet the criteria for diagnosis, you still need help to cope with the symptoms.

History of research

It is interesting that researchers, relying on literature, referring to the Iliad and other historical sources, proved that people at all times realized that for a terrible experience a person will always respond with a strong emotional reaction.

Nevertheless, as a formal diagnosis, the term "posttraumatic stress disorder" appeared only in 1980, that is, quite recently in terms of the history of psychiatry.

During the Civil War in the United States, the Crimean War, the First and Second World Wars, the Korean War, the Vietnam War - in all of these events at the beginning of the conflict, physicists, psychologists or mental health specialists behaved as if they had forgotten all previous experience previous wars.

And each time, at the end of one of them, a clinical examination was carried out at a level high for this historical period.

Soldiers during the Battle of the Somme in World War I, many of whom survived the "trench shock." During the First World War, a lot of work was done with what was then called a trench shock, or a traumatic neurosis.

In the US psychiatrist Abram Cardiner wrote a lot on this subject, and Sigmund Freud wrote about this at the end of World War I and during the Second. When people see so many traumas, a serious understanding of the phenomenon begins, but on the other hand, it seems that there is a tendency that the knowledge of trauma and its importance is gradually lost in society after the main traumatic periods.

Post-traumatic syndrome

Man is able to adapt to various circumstances; With a change in our lives we are changing ourselves. The changes that take place in us help to survive, no matter what conditions we face. However, some events, especially prolonged in time, can cause a serious mental disorder, known as the "post-traumatic syndrome" (PTS).

What is post-traumatic syndrome?

Speaking of post-traumatic syndrome, we mean that a person experienced one or several traumatic events that deeply affected his psyche. These events so sharply differ from all previous experience or caused so much suffering that the person answered them with a stormy negative reaction. The normal psyche in such a situation naturally tends to soften the discomfort: a person who has experienced such a reaction fundamentally changes his attitude to the surrounding world, in order to live at least a little easier.

How long can the TCP last?

If the trauma was relatively small, then the increased anxiety and other symptoms of the syndrome will gradually pass for several hours, days or weeks. If the trauma was severe, or the traumatic events were repeated many times, the painful reaction may persist for many years.

The other side of the post-traumatic syndrome refers to the inner world of the individual and is associated with the person's reaction to the experiences experienced. We all react in different ways: a tragic incident can cause serious trauma to one and almost not affect the psyche of another. It is also very important, at what time the event occurs: the same person at different times can react in different ways.

Is PTS a psychological deviation?

At the same time, a person strives to think, feel and act in such a way as to avoid heavy memories. Just as we acquire immunity to a particular disease, our psyche develops a special mechanism to protect against painful experiences. When this does not happen and the person fails, for whatever reasons, to find a way to defuse the internal tension, his body and psyche find a way to somehow apply to this tension. This, in principle, is the mechanism of the post-traumatic syndrome, the symptoms of which in complex look like a mental deflection, although in reality they are just a deeply rooted way of behavior associated with extreme events in the past. Clinical symptoms of PTS:

Unmotivated vigilance. A person closely follows everything that is happening around him, as if he is constantly in danger.

The explosive reaction. At the slightest surprise, a person makes rapid movements (rushes to the ground at the sound of a low-flying helicopter, sharply turns around and takes a pose when someone approaches him from behind).

Dullness of emotions. It happens that a person has completely or partially lost the ability for emotional manifestations. It is difficult for him to establish close and friendly ties with others, he lacks joy, love, creativity, playfulness and spontaneity

Aggressiveness. The desire to solve problems with the help of brute force. Although, as a rule, this refers to physical force, sometimes there is psychic, emotional and verbal aggression. Simply put, a person tends to use force pressure on others whenever he wants to achieve his, even if the goal is not vital.

Memory impairment and concentration of attention. The person experiences difficulties when it is required to concentrate or remember something

Depression. In the state of posttraumatic syndrome, it seems to the person that everything is meaningless and useless. This feeling is accompanied by nervous exhaustion, apathy and a negative attitude towards life.

General anxiety. It manifests itself on the physiological level (aches in the back, stomach cramps, headaches), in the psychic sphere (constant anxiety and concern, "paranoid" phenomena such as unreasonable fear of persecution), in emotional experiences (a constant sense of fear, self-doubt, guilt complex ).

Fits of rage. Such attacks often occur under the influence of narcotic substances, especially alcohol, but they happen on their own.

Propensity to abuse of narcotic and medicinal substances.

Unbearable memories. Perhaps, this is the most important symptom, giving the right to talk about the presence of PTS. In the memory of the patient suddenly emerge terrible, ugly scenes associated with a traumatic event. These memories can arise both in a dream and during wakefulness. In reality they appear in those cases when the surrounding situation is somewhat reminiscent of what happened at that time, i.e. during a traumatic event: a smell, a sight, a sound, as if come from that time. Bright images of the past fall on the psyche and cause a strong syndrome.

Two types of uninvited memories

Unbidden memories that come in a dream are called nightmares. Dreams of this kind are, as a rule, of two types: the first, with the accuracy of video recording, transmit the traumatic event as it is imprinted in the memory of the person who survived it; in dreams of the second type, the environment and characters can be completely different, but at least some of the elements (face, situation, sensation) are similar to those that took place in the traumatic event. A person awakens from such a dream completely broken; his muscles are tense, he is sweating all over. In the medical literature, night sweats are sometimes seen as an independent symptom, on the grounds that many patients wake up with sweat, but do not remember what they dreamed.

Hallucinatory experiences. This is a special kind of uninvited memories of traumatic events, with the difference that in a hallucinatory experience, the memory of what happened is so vivid that the events of the current moment seem to fade into the background and seem less real than memories. In this "hallucinatory", detached state, a person behaves as if he were again experiencing a traumatic event in the past; he acts, thinks and feels the same way as when he had to save his life.

Who is affected by hallucinatory experiences?

Hallucinatory experiences are not peculiar to all patients: it is just a kind of uninvited memories, for which a special brightness and tenderness is characteristic. They often arise under the influence of narcotic substances, in particular alcohol, however hallucinatory experiences can appear in a person and in a sober state, as well as for someone who never uses drugs.

Insomnia (difficulty falling asleep and intermittent sleep). When a person is visited by nightmares, if a person is afraid to fall asleep and see it again. Regular lack of sleep, leading to extreme nervous exhaustion, complements the picture of post-traumatic syndrome. Insomnia is also caused by a high level of anxiety, an inability to relax, as well as a lasting feeling of physical or mental pain.

Thoughts of suicide. The patient constantly thinks about suicide or plans any actions that ultimately lead him to death.

The guilt of the survivor. Feelings of guilt because of having survived the hard trials that cost others lives are often inherent in those who suffer from emotional deafness (inability to experience joy, love, compassion, etc.) since the traumatic events. Many victims of the PTS are ready for anything, just to avoid a reminder of the tragedy, the death of their comrades.

Methods of treatment

The picture of a person's mental state and behavior, which is called the syndrome of post-traumatic syndrome, describes a certain way of existence in this world. The traditional approach - allowing patients with PTS to participate in various adaptation programs - does not solve the problem, since the main thrust of all these programs is not to help the person get rid of the psychological problem, but in an attempt to bring his changed perceptions of the surrounding reality to the norms adopted in a given society.

Unfortunately, many doctors forget the fact that the true physical and mental health is not to meet social norms and standards, but to come to terms with yourself and the real facts of your life. If today the circumstances of life are greatly influenced by troubling memories, behavior, way of thinking and feelings, inherited from the past, it is very important to honestly admit their existence, even if it seems "abnormal" to somebody.

Tablet to me, tablet

Modern researchers solve the same problem as their predecessors - they create a "sleepless", tireless fighter. The head of the Pentagon research agency determined the motivation for such research is very simple: "Eliminating the need for sleep during active hostilities will fundamentally change the strategy and tactics of warfare."

One of the programs being developed in the US is the CAP (Continuous Assisted Performance Program). Its leader, John Carney (John Carney) defines the purpose of research as "seven days and seven nights without sleep." At the same time, similar abilities of birds and animals are taken as a basis. It is widely known, for example, that dolphins are constantly in a state of wakefulness (otherwise they simply will not be able to breathe in the aquatic environment). Sparrowheads also do not sleep for a long period, in a word, there is a chance to find a solution to the problem in Mother Nature.

Other programs are looking for an answer in chemistry. Benefit of its modern capabilities are truly limitless. So, the Ministry of Defense of Great Britain bought a huge amount of a psychostimulant with a rather inconsistent reputation for providing its troops in Iraq. The defense department purchased more than 24,000 capsules of the drug Provigil, which is licensed in Britain and the US for use only in cases of severe neuropsychiatric disorders associated with pathological daytime drowsiness.

Experts believe that this psychostimulant can also be used "outside the license" to keep pilots of military aviation and special forces in a state of constant wakefulness. The British began using this drug back in 2001 in Afghanistan, and France and the United States have long and actively used psychostimulants in their armies. The French Foreign Legion has been using similar drugs since 1991, and in the US Army, its widespread use was temporarily postponed after the April 2002 incident.

Then in Kandahar, two F-16 pilots bombed a column of the Canadian military by mistake, as a result of which 4 people were killed and 8 were injured. The subsequent investigation found that both pilots were under the influence of the amphetamine stimulant, which was received before the task was completed. The British plan to use a psychostimulant to maintain "in the form" of special forces soldiers who participate in operations lasting more than 48 hours, as well as for pilots during prolonged patrolling of airspace.

It should be noted that the exact mechanism of action, as well as possible side effects of the drug Provigil are unknown even to the manufacturer. According to some data, Provigil can cause increased nervousness, irritation, irritability, dizziness and headache. In addition, gastrointestinal disorders (nausea and abdominal pain), increased blood pressure and artemia are possible.

Military interest in Provigil is explained by the desire to find an alternative to existing stimulants - caffeine and amphetamine. Caffeine has a low enough efficiency, and amphetamine is addictive, growing into an amphetamine addiction. Nevertheless, after the Second World War, a classic study of the doctors of Grinker and Spiegel on pilots appeared, which can be considered a remarkable description of post-traumatic stress disorder.

In the late 1950s and early 1960s, a group of psychiatrists studied PTSD. Robert J. Lifton was one of them, as well as my father, Henry Crystal. After that there was a whole group of people, including Matt Friedman, Terry Keane, Dennis Cerney and others who worked with veterans of the Vietnam War, as well as many other researchers from around the world, such as Leo Eitinger and Lars Veiset. This field of research, this problem is relevant in all countries, and in every country there are people who are studying this phenomenon and are contributing to the overall work.

One of the important researchers of PTSD was my father, Henry Crystal, who passed away last year. He was one of the survivors of Auschwitz, he also went through other camps. When he was released from the camps, he decided to try to go to a medical school. Eventually he moved to the US with his aunt, graduated from a medical school, began to engage in psychiatry and began working with other survivors of the Nazi death camps. Examining other survivors applying for disability benefits, he carefully studied their cases, which became one of the earliest descriptions of the syndrome of post-traumatic stress disorder.

He was a psychoanalyst, so he tried to develop psychotherapeutic approaches from the psychoanalytic point of view, which included the elements of behavioral psychology, cognitive neurology and other disciplinary fields that interested him.

Thus, he developed some improvements in therapy that help people with PTSD, who often had difficulty expressing emotions and feelings.

Classification of trauma

One of the important results of such cultural experiences as war and other major shocks was that we began to expand the assessment of situations that could lead to trauma (adult trauma, trauma in children, physical or sexual violence), or situations where the patient is witnessing terrible events and so on.

Thus, PTSD covers not only social groups such as soldiers in society, for whom PTSD is a significant problem.

What is often misunderstood about PTSD is that it is not so important how serious the events were from the point of view of another person. Despite the fact that there are attempts to classify or in some sense narrow down the set of events that would be considered truly traumatic, for individual people the cause of the injury is not so much the objective danger of the event as its subjective significance.

For example, there are situations in which people react sharply to what appears to be quite innocuous. This happens, as a rule, because people believe that life in the form in which they knew it, ended; something deeply tragic and destructive has happened to them, and this is perceived by them just like that, even if for others everything looks different.